BOSTON — A trip to the emergency room ended in a troubling, and first-of-its kind diagnosis for an otherwise healthy teenager who had contracted COVID-19 and sought help from doctors at Mass General Brigham.
In a study published Tuesday in the journal Pediatrics, researchers determined the 15-year Massachusetts girl was suffering from bilateral vocal chord paralysis, and immediate action was needed to help her.
Doctors at Mass Eye and Ear decided the girl needed a tracheostomy, or a surgically created opening in her windpipe – to relieve her breathing difficulties.
Researchers say she remained tracheostomy-dependent for more than 13 months after the initial treatment, suggesting this type of nerve complication may not be temporary. Doctor say there have been several reports of paralysis in one or both vocal cords of adults as a complication of COVID-19, but this is the first report of the complication in an adolescent.
“Given how common this virus is among children, this newly recognized potential complication should be considered in any child presenting with a breathing, talking or swallowing complaint after a recent COVID-19 diagnosis,” said study author Danielle Reny Larrow, a resident in the Department of Otolaryngology-Head and Neck Surgery at Mass Eye and Ear. “This is especially important as such complaints could be easily attributed to more common diagnoses such as asthma.”
That girl finally had the tracheostomy removed after 15 months, and just in time for her high school prom.
“She told me she was not going to go to the prom with her tracheostomy in place,” said Dr. Christopher Hartnick, of Mass Eye and Ear. “We decided to intervene so that she could graduate high school and go to her prom tracheostomy-free, which she did.”
Doctor’s say the teen’s symptoms resolved after she received the long-term tracheostomy.
“To have a young, healthy, vibrant high schooler all of a sudden lose one of their important cranial nerves such that they can’t breathe is highly unusual and took some parsing,” said Dr. Hartnick, “The fact that kids can actually have long term neurotrophic effects from COVID-19 is something that it’s important for the broader pediatric community to be aware of in order to be able to treat our kids well.”
The case, is published in the December 19th in the journal Pediatrics.
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